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低剂量肺部放疗对重症 COVID-19 肺炎而言是一种治疗选择吗?

Is Low-Dose Lung Radiotherapy for Severe COVID-19 Pneumonia a Therapeutic Alternative?

作者信息

Safini Fatima, Amaoui Bouchra, Oqbani Kenza, Abbaoui Sanae, Semghouli Slimane

机构信息

Department of Radiation Therapy, Souss-Massa University Hospital, Agadir, MAR.

Faculty of Medicine and Pharmacy, Ibn Zohr University, Agadir, MAR.

出版信息

Cureus. 2024 Jul 21;16(7):e65033. doi: 10.7759/cureus.65033. eCollection 2024 Jul.

DOI:10.7759/cureus.65033
PMID:39165439
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11334754/
Abstract

Low-dose radiotherapy (LD-RT) has historically been used to treat severe bacterial and viral pneumonia due to its immunomodulatory properties. However, this technique has been delayed since the advent of antibiotics and the carcinogenic risk associated with radiation therapy. Currently, it represents an alternative therapeutic in the SARS-CoV-2 pandemic which leads sometimes to fatal pneumonia, especially given the limited availability of effective treatments for severe forms of pneumonia. Numerous in vitro and in vivo studies have demonstrated the anti-inflammatory effect of LD-RT and have reported clinical and biological improvement in patients with severe pneumonia. In this literature review, we report the data and results of various published clinical trials.

摘要

低剂量放疗(LD-RT)因其免疫调节特性,在历史上一直被用于治疗严重的细菌性和病毒性肺炎。然而,自抗生素问世以及放疗相关致癌风险出现以来,这项技术的应用有所延迟。目前,在新型冠状病毒肺炎(SARS-CoV-2)大流行中,它成为一种替代疗法,这种大流行有时会导致致命性肺炎,特别是考虑到针对重症肺炎的有效治疗方法有限。大量的体外和体内研究已经证明了低剂量放疗的抗炎作用,并报告了重症肺炎患者的临床和生物学改善情况。在这篇文献综述中,我们报告了各种已发表临床试验的数据和结果。

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Is Low-Dose Lung Radiotherapy for Severe COVID-19 Pneumonia a Therapeutic Alternative?低剂量肺部放疗对重症 COVID-19 肺炎而言是一种治疗选择吗?
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本文引用的文献

1
Efficacy of low-dose lung radiotherapy in the management of COVID-19 patients: a randomised, open-label study.低剂量肺部放疗在 COVID-19 患者管理中的疗效:一项随机、开放标签研究。
Br J Radiol. 2023 Dec;96(1152):20230022. doi: 10.1259/bjr.20230022. Epub 2023 Oct 24.
2
Low-dose radiation therapy suppresses viral pneumonia by enhancing broad-spectrum anti-inflammatory responses via transforming growth factor-β production.低剂量辐射疗法通过产生转化生长因子-β增强广谱抗炎反应来抑制病毒性肺炎。
Front Immunol. 2023 May 25;14:1182927. doi: 10.3389/fimmu.2023.1182927. eCollection 2023.
3
Treatment of COVID-19 pneumonia with low-dose radiotherapy plus standard of care versus standard of care alone in frail patients : The SEOR-GICOR IPACOVID comparative cohort trial.在虚弱患者中,低剂量放射治疗联合标准治疗与单独标准治疗治疗 COVID-19 肺炎的比较:SEOR-GICOR IPACOVID 比较队列试验。
Strahlenther Onkol. 2023 Sep;199(9):847-856. doi: 10.1007/s00066-023-02067-9. Epub 2023 Mar 31.
4
Low-Dose Radiotherapy for Patients with Pneumonia Due to COVID-19: A Single-Institution Prospective Study.低剂量放射治疗新型冠状病毒肺炎患者:一项单机构前瞻性研究
Biomedicines. 2023 Mar 11;11(3):858. doi: 10.3390/biomedicines11030858.
5
A pilot phase Ib/II study of whole-lung low dose radiation therapy (LDRT) for the treatment of severe COVID-19 pneumonia: First experience from Africa.一项针对严重 COVID-19 肺炎治疗的全肺低剂量放射治疗(LDRT)的初步 I b/II 期临床试验:来自非洲的首次经验。
PLoS One. 2022 Jul 1;17(7):e0270594. doi: 10.1371/journal.pone.0270594. eCollection 2022.
6
Interim Analysis of Impact of Adding Low Dose Pulmonary Radiotherapy to Moderate COVID-19 Pneumonia Patients: IMpaCt-RT Study.低剂量肺部放疗对中度新冠肺炎肺炎患者影响的中期分析:IMpaCt-RT研究
Front Oncol. 2022 Mar 29;12:822902. doi: 10.3389/fonc.2022.822902. eCollection 2022.
7
Low-dose Radiation Therapy in the Management of COVID-19 Pneumonia (LOWRAD-Cov19). Final results of a prospective phase I-II trial.低剂量辐射疗法在 COVID-19 肺炎治疗中的应用(LOWRAD-Cov19)。一项前瞻性 I-II 期试验的最终结果。
Radiother Oncol. 2022 Jun;171:25-29. doi: 10.1016/j.radonc.2022.03.015. Epub 2022 Mar 31.
8
Whole lung irradiation as a novel treatment for COVID-19: Final results of the prospective randomized trial (WINCOVID trial).全肺照射治疗 COVID-19:前瞻性随机试验(WINCOVID 试验)的最终结果。
Radiother Oncol. 2022 Feb;167:133-142. doi: 10.1016/j.radonc.2021.12.024. Epub 2021 Dec 25.
9
The clinical efficacy of low-dose whole-lung irradiation in moderate-to-severe COVID-19 pneumonia: RTMX-20 trial.低剂量全肺照射治疗中重度 COVID-19 肺炎的临床疗效:RTMX-20 试验。
Radiother Oncol. 2022 Jan;166:133-136. doi: 10.1016/j.radonc.2021.11.013. Epub 2021 Nov 25.
10
Association Between mRNA Vaccination and COVID-19 Hospitalization and Disease Severity.mRNA 疫苗接种与 COVID-19 住院和疾病严重程度的关联。
JAMA. 2021 Nov 23;326(20):2043-2054. doi: 10.1001/jama.2021.19499.